Pre-existing conditions complicate Obamacare repeal

The GOP is struggling to reach a final deal on the amended American Health Care Act because some do not want to allow companies to charge people with pre-existing conditions more for coverage. House Speaker Paul Ryan may release an amendment on Wednesday addressing those concerns in order to increase support from moderates. File Photo by Mike Theiler/UPI

May 3 (UPI) — Republicans are struggling to reach a final agreement on a bill to repeal and replace the Affordable Care Act, or Obamacare, because some do not want to allow insurance companies to charge people with pre-existing conditions more for coverage.

Republicans last week finished amending the American Health Care Act — the GOP effort to replace the ACA — with more support of Freedom Caucus members. The staunchly conservative group was a holdout in March the first time the House attempted to pass the AHCA.

Though the proposed legislation does not remove the ACA’s ban on discrimination against people with pre-existing conditions, it does, however, allow states to apply for “limited waivers” set to undermine the ACA’s protections for those with pre-existing conditions. The waivers allow states to opt out of ACA standards setting minimum benefits that health plans must offer.

“From Day 1, I’ve supported the rights of those with pre-existing illnesses to be covered, and in my view this undermines that effort, and I can’t be a part of it,” Rep. Fred Upton, R-Mich., told reporters Tuesday. “Yes, there are ways to fix it. But the proposal that’s on the table now doesn’t work.”

The waiver also allows states to opt out of the community rating requirement that prevents insurers from charging different prices based on a client’s health status or age.

Under the AHCA’s amendments, insurance companies would still be required to cover older people and those with pre-existing conditions, but the companies will have the ability to charge them more through waivers, particularly if those who are insured have a lapse in coverage.

Rep. Tom Rooney, R-Fla., on Tuesday said he has confronted by “extremely angry” and “sincerely scared” constituents.

“You know, the most sincere anger I’ve noticed comes from people that are sincerely scared, people that may have a pre-existing condition that feel like they’re about to lose it and they’re going to die, and they’re going to die because of a vote that we might be taking,” Rooney told reporters on Tuesday. “And if we cannot explain to people that that is not going to happen, then it is going to be very difficult to ever bring a bill to the floor.”

House Speaker Paul Ryan and his team are expected to release an amendment Wednesday aimed at soothing concerns from moderate Republicans about how the bill treats those with pre-existing conditions, Politico reported.

Ryan in late March canceled the House vote over the GOP’s first effort under President Donald Trump to repeal and replace the ACA after it became clear the effort would not pass.

Many Freedom Caucus members said they did not support the bill because it did not do enough to dismantle Obamacare — describing the legislation as “Obamacare lite.” Some moderate Republican lawmakers said the bill goes too far by allowing insurers to charge more depending on pre-existing conditions and age.

Trump is helping whip support for the amended bill by calling members who oppose the bill. Trump will meet with opponents of the bill on Wednesday at the White House in an attempt to persuade the lawmakers

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